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poor

adjective Referring to a status wherein a person or persons lack enough money to live at a standard of comfort considered normal in a society. In 2009, 14.3% of Americans were poor; by race, 25% of Hispanics and Blacks are poor, 9% of Whites are poor.

leukemia

Hematology An uncommon–incidence, US 3.5/105/yr—malignant clonal expansion of myeloid or lymphoid cells characterized by an ↑ in circulating WBCs; leukemias may be an incidental finding when evaluating an unrelated clinical problem, or when the expansion compromises BM production of one or more cell lines causing anemia, thrombocytopenia, granulocytopenia; leukemias are divided by chronology–acute or chronic, by cell lineage–lymphoid, myeloid/myelocytic, monocytic or megakaryocytic and divided by stage of maturation or cell size Clinical BM infiltration by leukemia, resulting in anemia, thrombocytopenia, granulocytopenia, immune paralysis, ↓ B cells and CD4–helper T cells, ↑ CD8–suppressor T cells, infiltration and leukostasis, cranial nerve palsies, meningitis, lymphadenopathy, hepatosplenomegaly, testicular and cutaneous involvement, metabolic derangements–eg, ↑ Ca2+, K+, LD, ammonia, weight loss, less commonly, autoimmune hemolytic anemia, pallor and arthralgia Diagnosis Hx, physical exam, peripheral smear Management Chemotherapy, RT, BMT. See Accelerated leukemia, Acute leukemia, Acute lymphocytic leukemia, Acute myelocytic leukemia, Acute promyelocytic leukemia, Adult T-cell leukemia-lymphoma, Aleukemic leukemia, Biphenotypic leukemia, Central nervous system leukemia, Chemotherapy-induced leukemia, Chronic leukemia, Chronic lymphocytic leukemia, Chronic myelocytic leukemia, Chronic myelomonocytic leukemia, Congenital leukemia, Erythroleukemia, FAB classification, Hairy cell leukemia, Hand mirror cell leukemia, Herald state of leukemia, Mast cell leukemia, Megakaryoblastic leukemia, Multilineage leukemia, Plasma cell leukemia, Preleukemia, Prolymphocytic leukemia, Promyelocytic leukemia, Smoldering myeloid leukemia.
Leukemia Acute v. Chronic
Acute leukemia More common in children, 80% are ALL, often before age 10, peak at ages 3–7 in whites, ♂:♀ ratio, 1.3:1 Cell types Early pre-B cell 67%; pre-B cell 18%; B cell 1%; T cell 14%; 50-85% are cALLA positive–common acute lymphocytic leukemia antigen, CD10; 5% have Philadelphia chromosome Clinical ALL is more abrupt than AML, with petechial hemorrhage, bone and abdominal pain, headache and vomiting due to ↑ intracranial pressure, lymphadenopathy, splenomegaly, hepatomegaly Lab 70% have low-grade lymphocytosis–< 20 x 109 when diagnosed Evaluation Acute leukemia immunophenotypic profile Specimen EDTA–lavender top tube and sodium heparin–green top tube, peripheral blood smears Method of analysis Flow cytometry, immunofluorecesence Markers measured CD1, -2, -3, -4, -5, -7, -8, -10, -19. -20, -21, -33, -34, -56, megakaryocytic markers, HLA D/DR, kappa, lambda, TdT Management Protocols vary according to standard- or high-risk clinical features, and may include BMT
Chronic leukemia More common in adults/older children, often myelocytic; CML is Philadelphia chromosome positive; may occur < age 5 with myelomonocytosis, anemia, thrombocytopenia, lymphadenopathy; WBC count < 50 x 109, ≠ HbF, ≠ muraminidase; adult CML comprises 20% of all leukemias Clinical Gradual onset of fatigability, anorexia, splenomegaly; lymphadenopathy is uncommon Lab > 25 x 109/L leukemic cells in blood–often an absolute lymphocytosis of > 15 x 1010/L, < 10% blasts in BM, myeloid:erythroid ratio is 10-30:1, 90% of cases have low-to-absent leukocyte alkaline phosphatase and rarely also, ≠ vitamin B12 and B12-binding capacity Evaluation Chronic leukemia immunophenotype profile Specimen EDTA–lavender top tube and sodium heparin–green top tube, peripheral blood smears Method of analysis Flow cytometry, immunofluorescence Markers measured CD3, -5, -19, -20, -21, kappa, lambda Management see Chemotherapy, Induction Prognosis see Remission.
Leukemia–prognostic features
Acute lymphocytic leukemia
Good Age 2-10, CD10 positivity, hyperdiploid karyotype
Poor Age < 2; >10, B-cell phenotype, especially L2 phenotype by FAB classification, presence of chromosome translocations, CNS involvement, mediastinal masses, high initial WBC count
Acute myelocytic leukemia
Good Younger, presence of Auer rods, rapid therapeutic response
Poor Older, prior malignancy or therapy, multiple chromosome defects  
References in classic literature ?
But from what I see, family or no family, drunk or sober, the poor gets poorer and the rich richer every day.
If any of them have money, this is the chap, and, marry, he should share it with us poorer bodies.
A little after, he got to his feet very sore and shaken, the poorer by a purse which contained exactly one penny postage- stamp, by a cambric handkerchief, and by the all-important envelope.
Surely God will not permit the world to be the poorer by the loss of such a creature.
May I be permitted to say, sir," replied Conseil, "that I never reckoned on getting the prize; and, had the government of the Union offered a hundred thousand dollars, it would have been none the poorer.
To this you answered, O swineherd Eumaeus, "Stranger, though a still poorer man should come here, it would not be right for me to insult him, for all strangers and beggars are from Jove.
said De Winter, "I am at this moment as poor as he is, if not poorer.
I find that the poorer classes of this country display a marked desire for a higher ethical standard.
Sometimes a gleam of tenderness softened her eyes and manner, but this was rare; only when a pupil was sick, or when it pined after home, or in the case of some little motherless child, or of one much poorer than its companions, whose scanty wardrobe and mean appointments brought on it the contempt of the jewelled young countesses and silk-clad misses.
This distinction was rather a gratuitous concession made by the poorer and less polished part of the population than a right claimed by the favored few.
Several of the Snakes were slain on the spot; the residue, with their three Canadian allies, fled to the mountains, stripped of horses, buffalo meat, everything; and made their way back to the old encampment on Snake River, poorer than ever, but esteeming themselves fortunate in having escaped with their lives.
Thus, if we find a spiritual sage whose unseen, inestimable influence has exalted the moral standard of mankind, we will choose for his companion some poor laborer who has wrought for love in the potato field of a neighbor poorer than himself.